Clinical Indicators from CIHI

Your Health System

How does quality of care at the Veterans Memorial Lodge at Broadmead compare to the long-term care (LTC) sector across Canada?  To sum it up in one word … excellent! 

How do we know?   The Canadian Institute of Health Information (CIHI) has a long-term care component in its public health system performance reporting website called Your Health System.  Nine LTC indicators are available measuring the safety, quality of life and general health of LTC residents across Canada. The most recent data available are from the fiscal year 2014-15.

Quality Indicators

Clinical Indicators for:

The Nigel Program

We also are very proud of the high quality of care we provide at the Nigel Program.  Please note that data on the Nigel Program has not been included in the CIHI website because all smaller residential care programs were removed from the national dataset.  However, we do use the RAI-MDS data to inform care planning processes and to identify quality improvement priorities. Also, from the results of our bi-annual resident surveys, we obtain detailed information that is used to focus our quality improvement planning.

Veterans Memorial Lodge at Broadmead
  • The Veterans Memorial Lodge at Broadmead compares very favourably with Island Health, provincial and national percentages and performs well above the national average on some indicators:
    • These results are even more positive given that the CIHI data also indicates that the population of residents at the Lodge is considerably older and frailer than the national long term care average.
  • The Lodge has very effective medication management practices that ensure residents are receiving only appropriate medications.  This is demonstrated by a significantly lower percentage of residents taking antipsychotic medications without a diagnosis of psychosis.
  • The Lodge also has effective pain management practices that ensure residents live as comfortably as possible.  This is demonstrated by a significantly lower percentage of residents who experience worsened pain.
  • The Lodge rarely ever uses daily physical restraints in resident care resulting in a percentage approaching zero.  This is in contrast to much higher rates of restraint usage across Canada.
    • With our emphasis on other fall prevention strategies this has allowed us to keep our percentage of falls at the Provincial average without resorting to the use of restraints.
  • The Lodge has an older than average population with many residents already completely dependent for transfer and/or locomotion.  These older, more dependent residents are less likely to have improvements in their abilities to transfer or move themselves.  As the average length of stay at the Lodge is declining, our program continues to shift to focus more on providing high quality end-of life care, during which improved physical functioning is not anticipated.  As a result, the Lodge is naturally below both provincial and national averages for the “Improved or remained independent in mid-loss ADLs” indicator.

 

 

Indicators - measured in %               2013-2014

TLAB

VIHA

Provincial

National

1

Improved or remained Independent in mid-loss ADLs

9.9

34.7

33.3

32.2

2

Worsened or remained dependent in mid-loss ADLs

28.3

34.7

31.3

34.0

3

Worsened mood from symptoms of depression

23.9

22.7

17.1

23.8

4

Taken antipsychotics without a diagnosis of psychosis

8.1

33.5

33.2

30.3

5

Has fallen

17.1

17.6

16.1

14.9

6

Worsened stage 2-4 ulcers

3.4

3.7

3.2

3.0

7

Daily Physical Restraints

2.3

12.7

11.6

9.6

8

Has pain

13.6

21.4

16.7

10.2

9

Worsened pain

8.9

14.0

10.6

11.3

 

Mean age

88

85

85

85

 

 

Explanation of 9 Quality Indicators:

  • Percentage of residents who improved or remained Independent for “Transfer and locomotion”.  Broadmead has few residents who do not require at least Supervision for these ADL tasks and with the advanced age of our population few have the potential to improve.
  • Percentage of residents who worsened or remained “Dependent” for Transfer and Locomotion. 
  • Percentage of residents with a higher ‘Depression Rating Score’ than on their last assessment. The ‘Depression Rating Score’ goes from 0-14 and very few of the residents at Broadmead have scores above 4 or 5.
  • Percentage of residents on Antipsychotics without Schizophrenia, Huntington’s disease or who are having Delusions or Hallucinations.
  • Percentage of residents who had a fall, meaning “any unintentional change in position where the resident ends up on the floor, ground or other lower level such as the bed or a chair”.
  • Percentage of residents with a Stage 2 or 3 ulcer that became a stage 3 or 4.
  • Percentage of residents who were physically restrained from their normal ability to move and which they cannot remove themselves.
  • Percentage of residents who experience ‘Moderate pain’ daily or ‘Excruciating pain’ at any time.
  • Percentage of residents whose pain experience worsened or became more frequent.